Relationship Of Visceral Fat And Epicardial Adipose Tissue With Brachial-Ankle Pulse Wave Velocity In Type 2 Diabetic Macrovascular Complication

[Objective] Application of ultrasound imaging methods to observe the characteristics of epicardial adipose tissue(EAT)in patients with type 2 diabetes and healthy subjects;visceral fat meter to measure visceral adipose tissue(VAT)and subcutaneous fat in patients with type 2 diabetes,healthy people The characteristics of the organization(SAT).To investigate the correlation between EAT,VAT,carotid intima-media thickness(IMT)and brachial-iliac arterial pulse wave velocity(ba PWV)in type 2 diabetic patients with macrovascular disease.To explore the possible mechanism of the association between EAT,VAT,SAT and diabetic macroangiopathy in diabetic patients;the correlation between EAT and VAT,SAT,provides new ideas for the prevention and treatment of diabetic macroangiopathy.Whether the measurement of VAT can be used as a predictor of type 2 diabetes arteriosclerosis.[Methods]Collected 80 patients with type 2 diabetes in our Department of Endocrinology and Metabolism from February 2018 to April 2018.According to the entry and exit criteria,61 people were finally selected.And collect 11 healthy people in the physical examination center of our hospital during the same period.Divided into three groups: normal control group(NC group)11 cases,mean age(39±10.81)years,diabetes without macrovascular disease group(DM1 group)12 people,mean age(54.42±7.79)years old,diabetes with large vessels There were 49 patients in the disease group(DM2 group)with a mean age of(61.04±8.55)years.Waist circumference(WC),hip circumference(HIP),height,weight,systolic blood pressure(SBP),and diastolic blood pressure(DBP)were measured.Diabetes duration and smoking history were recorded.Body mass index(BMI)and waist-to-hip ratio were calculated according to the formula.Detection of glycosylated hemoglobin(Hb A1c),fasting plasma glucose(FPG),blood lipids,blood uric acid,C-reactive protein(CRP),fibrinogen.Measure ba PWV,IMT.The thickness of the EAT was measured using a GE Vivid 7 ultrasound diagnostic apparatus.Using the Omron HDS-2000 visceral fat test apparatus,the visceral fat area(VAT)and the abdominal subcutaneous fat area(SAT)were measured.SPSS 20.0 system software was used for statistical analysis.Measured data were expressed as mean±standard deviation.Pairwise comparisons of measurement data were performed using independent sample T-tests.Randomly designed one-way analysis of variance(ANOVA)was used for comparison between multiple groups.The data were analyzed using X2 and the correlation analysis was performed using person correlation analysis and multiple linear regression analysis.And using the receiver operating characteristic(ROC)curve to understand the predictive value of EAT,VAT,IMT on the presence of diabetic macrovascular disease,and determine the diagnostic cut-point value according to the most approximate index.[results]1.Person correlation analysis between EAT,VAT,IMT and index in diabetic group:(1)EAT was positively correlated with age,LDL,ba PWV,VAT;(2)VAT and body weight,BMI,neck circumference,waist circumference,hip circumference,waist-to-body ratio,waist-hip ratio,SAT,Positive correlation between EAT and CRP;(3)IMT was positively correlated with waist circumference,BMI,and CRP.2.Multiple linear regression analysis was used to analyze the relationship between EAT and task grouping: Although EAT thickness increased sequentially in the NC group,DM1 group,and DM2 group,the subject group had no significant effect on EAT.3.The correlation between ba PWV and various indexes in diabetes mellitus combined with macrovascular disease group: Pearson correlation analysis showed that ba PWV was positively correlated with EAT,Hb A1 C,and fibrinogen.Multivariate regression analysis was performed.The results showed that EAT was positively correlated with ba PWV..4.The predictive value of ultrasound-measured EAT for diabetic macroangiopathy:The area under the ROC curve is 0.721(95% confidence interval is 0.531-0.911 P=0.018),the cut-point value is 3.15 mm,and the sensitivity is 0.837.The specificity is 0.667.[Conclusion]1.The thickness of EAT in the normal control group,diabetic group without macrovascular disease group and diabetes combined macrovascular disease group showed an increasing trend,and EAT thickness was positively correlated with ba PWV in diabetic macrovascular disease group,suggesting that EAT increased.The increase in thickness may play an important role in the development of diabetic macroangiopathy.2.In diabetic patients,the thickness of EAT is positively correlated with ba PWV,indicating that the thickness of EAT in diabetic patients can predict diabetic macroangiopathy.In diabetic patients,EAT predicts diabetic macrovascular disease.3.The thickness of EAT was positively correlated with low-density lipoprotein,ba PWV,and VAT,indicating that the thickening of EAT is closely related to the disorder of lipid metabolism and the increase of VAT in patients with diabetes mellitus.Disturbance of lipid metabolism may promote the occurrence of atherosclerosis.Causes macrovascular disease.EAT can predict visceral fat content.4.Diabetes with major vascular disease and diabetes duration,age,diabetes duration,age is an independent risk factor for diabetic macrovascular disease.5.Hyperglycemia is a risk factor for atherosclerosis.